Lake Mills Care Center - Lake Mills Nursing Home

General Information

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Federal Provider Number
165366
Provider Name
LAKE MILLS CARE CENTER
Provider Address
406 SOUTH TENTH AVENUE EAST
LAKE MILLS, IA 50450
Provider Phone Number
(641) 592-4900
Provider SSA County
940
Provider County Name
Winnebago
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
78
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ABCM CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1997-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.13723
Reported LPN Staffing Hours per Resident per Day
0.55213
Reported RN Staffing Hours per Resident per Day
0.74681
Reported Licensed Staffing Hours per Resident per Day
1.29894
Reported Total Nurse Staffing Hours per Resident per Day
3.43617
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06277
Expected CNA Staffing Hours per Resident per Day
2.53756
Expected LPN Staffing Hours per Resident per Day
0.60162
Expected RN Staffing Hours per Resident per Day
0.92117
Expected Total Nurse Staffing Hours per Resident per Day
4.06036
Adjusted CNA Staffing Hours per Resident per Day
2.06660
Adjusted LPN Staffing Hours per Resident per Day
0.76172
Adjusted RN Staffing Hours per Resident per Day
0.60577
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41124
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
5.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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